AB1719-PARE MAPPING THE JOURNEY OF PEOPLE WITH RHEUMATIC DISEASES TO DIAGNOSIS IN GREECE
Authors: K. Spanidou, K. Koutsogianni, F. Asimakopoulou, E. Repa, I. Papadakis, M. Chatzigeorgiou, P. Pratsidou-Gertsi, A. Verikiou, M. Chatziioannou
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatic diseases (RD) are chronic mostly autoimmune diseases, multi- dimensionally affecting the musculoskeletal system and possibly other organs. Additionally, they impact the patient and family quality of life in respect to health, work, socialization and future perspectives. Previous data indicate that early diagnosis of inflammatory and other RDs is important in order to improve long-term outcome. <h3>Objectives</h3> To capture the journey of RD Greek patients from disease onset to diagnosis aiming to define gaps regarding the early management and uneventful outcome of these potentially debilitating chronic diseases. <h3>Methods</h3> An online questionnaire survey of patients with several types of RDs was uploaded by the Greek Federation REUMAZEIN, an acronym meaning co-living with an RD. 463 patients - all members of the Federation- responded to the call and were enrolled in the study. <h3>Results</h3> The majority were females (81%), mostly under 60yrs old (73%) and were residents of urban/suburban areas (65%). In respect to education, they were mainly graduate or postgraduate degree holders (56%). The prevailing RDs were RA (178) 38%, SLE (105) 23%, AS (61) 13% and PsA (58) 13%, respectively. The total lag time (mo) was 10.3. In respect to RD kind, it ranged from 5.9 for JIA to 19.7 for AS, respectively. The delay from disease onset to diagnosis was mainly attributed to patient underassessment of symptoms (53%) or ignorance of the proper MD specialist for these conditions (45%). Only a minority of participants (36%), reported that the diagnosis was made by the first specialty they had initially visited. The initial physician's (MD) specialist for all but SLE patients, was an orthopedic surgeon (33-60%), whereas for SLE ones, an internist (32%). The initial MD failed to establish the diagnosis in 64% pts, principally in AS ones (82%). Alternatively, rheumatologists as the primer reached MD, established the diagnosis in 60% of patients. Lag time to first visit in non-Rheumatology specialists and the corresponding diagnosis was 26mo; for AS pts it reached 50.9mo, respectively. The average lag time from symptom appearance to the first MD visit was 21.3mo and from the 1st visit to final diagnosis 72.2 mo. All patients reported as the most important problem until the final diagnosis, the lag time to diagnosis (36%), followed by a misdiagnosis (33%). Interestingly, those who looked for a second assessment pre-diagnosis, reported higher percentage either of delay or misdiagnosis (49%, 44%, respectively). The degree of satisfaction regarding information received by the MD who established the final diagnosis was totally high (3.5/5) and was irrespective of the RD type. At final diagnosis, patients were highly satisfied regarding information received by the MD for their most important problem, too. In respect of satisfaction to final diagnosis by rheumatologists vs. non-rheumatologists, the rates did not significantly differ. <h3>Conclusion</h3> Findings of this study indicate that the initial patient visit with an RD to the proper MD specialty, is highly important. A visit to a trained Specialist for RD as a Rheumatologist, significantly reduces lag time to diagnosis and leads to an early management and optimal prognosis. Most of the patients expressed a high rate of satisfaction at the establishment of final diagnosis in respect to the MD and his/her skill in problem solving. Therefore, informing and educating the public regarding the early recognition of initial symptoms and early guiding to an experienced MD specialty, would effectively improves the management and co-living with RDs. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.